**3. Symptoms of erotomania**

The chief feature of erotomania is a fixed, false and delusional belief that another person is deeply or obsessively in love with them. The other person may not even be aware of the existence of the person with erotomania. Often, there is no evidence of the other person's love. A person with this disorder might talk about the other person incessantly. They may also be obsessed with trying to meet with or communicate with this person so that they can be together. The behaviour associated to this disorder includes persistent efforts to make contact through stalking, written communication and other harassing behaviours.

The sufferer can also have this belief that their object of affection is sending secret, personal and affirming messages back. This belief can be precipitated by the targeted person making it known that the attention is unwanted. Individuals with erotomania can also act like a threat to their object of affection. Often, this threat is underestimated as a risk factor when the severity of this condition is evaluated. The following are the characteristics generally demonstrated by patients with erotomania [2, 5]:


In some instances, there can be anger about this perceived rejection associated with acting out behaviour.


Psychotic breaks: One more interesting aspect related to this disorder is that the course of erotomania is of two types. One is that it may happen over a long period of time and second, only in short episodes. These short episodes also come to be known as "psychotic breaks". Psychotic breaks are a common symptom of other mental health conditions. They involve an abrupt worsening of delusions or other psychotic features. They may occur in disorders such as schizophrenia, schizoaffective disorder, major depressive disorder with psychotic features, bipolar disorder or Alzheimer's disease.

**Aetiology:** Though the real cause behind this disorder is largely unknown, some studies have suggested that delusions may develop as a way of managing extreme stress or trauma. Genetics and personality patterns may also contribute to the development of this disorder.

One major factor which has been emphasized is the role of psychodynamic factors in the emergence of this disorder. Many authors have written about the psychodynamic aetiology of fantasy lover's syndrome and have said that this delusion acts as a gratification to the individuals' narcissistic needs. Every individual has this basic need to be loved. But when an individual is rejected by the society, he has to go through that perceived sense of rejection.

This, in turn, develops the fantasy that some other human being is in love with them. By developing such kind of a belief, they tend to feel important in their own eyes and are able to cope with the societal rejection. Kraepelin was of the view that it develops as a compensation for the disappointments of life. De Clerambault highlighted the idea of sexual pride. He elaborated this idea as when there is an absence of affective and sexual approval in an individual's life, this stimulates the development of erotomania in order to satisfy the individual's pride.

Another psychodynamic explanation which was given by Hollender and Callahan [8] says that this disorder develops as a result of an ego deficit. The sufferer feels that he/she is not attractive enough. Segal says that erotomanic delusion results from the patient's need for love. The sufferer relates his need for love as a way to gain approval. Taylor highlighted the idea that the individual's loneliness, isolation and extreme dependence on others also leads to the development of erotomanic disorder.

*De Clerambault Syndrome: Current Perspective DOI: http://dx.doi.org/10.5772/intechopen.92121*

**Diagnosis:** Erotomania has flouted easy categorization for several years. De Clerambault syndrome or erotomanic delusion is a rare delusional disorder which makes the diagnosis of erotomania very challenging. Though Kraepelin and De Clerambault had discussed this syndrome in detail, it appeared officially as a diagnosis for the first time in DSM-III R as a subtype of delusional disorder. Erotomanic delusions may be a part of schizophrenia, schizoaffective disorders or mood disorders. Thus, much care should be taken before reaching to a confirm diagnosis because the treatment and management of the disorder is planned as per the diagnosis. Rudden et al. [9] conducted a study on 28 patients with erotomanic delusions and compared them to 80 patients with other delusions and found that erotomanic patients had significantly more manic symptoms than the comparison group and more affective diagnosis. The following conditions must be met before a stand-alone diagnosis of erotomania can be made:

